The assault on the Liverpool care pathway

Re: The assault on the Liverpool care pathway

I welcome the debate on the Liverpool Care Pathway but it is sad to see one of Britain’s most courageous journalists – Melanie Phillips - misrepresented by Margaret McCartney. The article states that ‘Phillips…seems to insist that doctors must provide ineffective and potential harmful interventions of no value and at all costs, which is neither in the best interest of the patient nor the ethics and duties of medical professionalism.’

I have read two of Melanie Phillips’s recent columns [1][2] on the LCP and she doesn’t even come close to these sentiments. In fact she states the opposite: ‘I had already written that, when someone was truly dying, withdrawing food or treatment was merely long-acknowledged good medical practice. And if that was all the LCP was doing, that was fine.’[1]

What she and concerned patients are saying is that there are too many stories of patients put on the Liverpool Care Pathway who should never have been on it in the first place. Allegations of the deliberate withholding of fluids or food to patients who are not even dying should be thoroughly investigated.

It is disappointing that the profession has closed ranks on this issue and retreated again into paternalistic medicine when what is needed is an informed debate, a bit of humility and a listening ear to what patients and the journalists who represent them are actually saying.

In the same issue of the BMJ there is an anonymous report about neonates who are not wanted, being dehydrated to death.[3] The absence of an outcry over this shows how conditioned to killing we have become. Journalists have the duty to hold the medical profession to account for every kind of abuse of power.